Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, Chongqing 400016, China.
Institute for AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention Chongqing 400042, China.
Int J Environ Res Public Health. 2020 Jan 30;17(3):875. doi: 10.3390/ijerph17030875.
Male migrant workers (MMWs) have been reported to be vulnerable to human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs). Chongqing, China is one of the major migration destinations and hotspots of HIV. This study aims to explore the prevalence of HIV, syphilis, and hepatitis C virus (HCV), as well as HIV-related knowledge and behaviors, among MMWs in Chongqing.
Questionnaire surveys were conducted, and blood samples were collected and examined among MMWs selected by two-stage stratified sampling in Chongqing from 2010 to 2018. The Cochran-Armitage trend test was conducted to observe the trends in the prevalence of HIV, syphilis, and HCV, as well as HIV-related knowledge and behaviors. The Chi-square test and Binary Logistic Regression were conducted to observe the distinctions between different groups.
The overall HIV prevalence was 0.6% with an increasing trend (0.2% to 0.9%, < 0.001), whereas the overall HCV prevalence was 0.5% with a decreasing trend (0.5% to 0.4%, < 0.001). The overall syphilis prevalence was 1.3% in the ≥50 age group, 1.0% in the 30-49 age group, and higher than 0.3% in the 16-29 group (X = 19.527, P < 0.001). An uptrend (80.2%-80.6%, < 0.001) was observed in correct HIV-related knowledge. The 16-29 ((Odds Ratio) OR: 1.575; 95%CI (Confidence Interval): 1.380-1.798; P < 0.001) and 30-49 (OR: 1.697; 95%CI: 1.495-1.926; P < 0.001) age groups had 1.575 and 1.697 times correct HIV-related knowledge more than the ≥50 age group. The proportion of subjects engaged in commercial sex in the past year (7.7%-13.3%, < 0.001), consistent condom use during this activity (20.5%-54.0%, < 0.001), and condom use in the last commercial sex (48.6%-72.1%, = 0.020) were increasing. The risk of engaging in commercial sex in the past year in the 16-29 age group was 0.768 times (OR: 0.768; 95%CI: 0.643-0.917; P = 0.003) less than that in the ≥50 age group. The risk of engaging in non-regular sex in the past year in the 16-29 (OR: 2.819; 95%CI: 2.317-3.431; P < 0.001) and 30-49 (OR: 1.432; 95%CI: 1.184-1.733); P < 0.001) age groups were 2.819 and 1.432 times more than that in the ≥50 age group. The risk of engaging in anal sex in the past year in the 16-29 age group was 6.333 times (OR: 6.333; 95%CI: 1.468-27.327); P < 0.013] more than that in the ≥50 age group. The proportion of consistent condom use during non-regular sex in the past year (10.9%-47.3%, < 0.001) and condom use in the last non-regular sex (40.8%-71.1%, < 0.001) increased remarkably. The possibilities of consistent condom use during commercial sex in the past year in the 16-29 (OR: 2.606; 95%CI: 1.847-3.677); P < 0.001) and 30-49 (OR: 1.632; 95%CI: 1.214-2.195; P = 0.001) age groups were 2.606 and 1.632 times more than that in the ≥50 age group. The possibilities of condom use in the last commercial sex in the 16-29 (OR: 1.805; 95%CI: 1.258-2.589; P = 0.001) and 30-49 (OR: 1.360; 95%CI: 1.016-1.821; P = 0.039) age groups were 1.805 and 1.360 times more than that in the ≥50 age group. The possibilities of consistent condom use during non-regular sex in the past year (OR: 1.628; 95%CI: 1.066-2.484; P = 0.024) and condom use in the last non-regular sex (OR: 1.671; 95%CI: 1.148-2.433; P = 0.007) in the 16-29 age group were 1.628 and 1.671 times more than those in the ≥50 age group, respectively.
An upward trend of HIV and a downward trend of HCV were observed among MMWs in Chongqing from 2010 to 2018. We also found an increase in commercial sex and inadequate condom use during high-risk behaviors among this population. The overall syphilis prevalence in the middle-aged and elderly groups was higher than in the young group, and elderly MMWs were more likely to engage in unprotected high-risk behaviors. Thus, targeted STI prevention for MMWs in Chongqing, especially those aged 50 years and above, is urgently needed.
男性农民工（MMWs）易感染人类免疫缺陷病毒（HIV）和其他性传播感染（STIs）。中国重庆是主要的移民目的地和 HIV 热点之一。本研究旨在探讨重庆 MMWs 中 HIV、梅毒和丙型肝炎病毒（HCV）的流行率，以及 HIV 相关知识和行为。
2010 年至 2018 年，我们采用两阶段分层抽样法在重庆选择 MMWs 进行问卷调查和血样采集检测。采用 Cochran-Armitage 趋势检验观察 HIV、梅毒和 HCV 流行率以及 HIV 相关知识和行为的变化趋势。采用卡方检验和二项 Logistic 回归观察不同组之间的差异。
总体 HIV 流行率呈上升趋势（0.2%至 0.9%，<0.001），而总体 HCV 流行率呈下降趋势（0.5%至 0.4%，<0.001）。≥50 岁年龄组的总体梅毒流行率为 1.3%，30-49 岁年龄组为 1.0%，16-29 岁年龄组的流行率高于 0.3%（X=19.527，P<0.001）。HIV 相关知识的正确比例呈上升趋势（80.2%-80.6%，<0.001）。16-29 岁（比值比（OR）：1.575；95%置信区间（CI）：1.380-1.798；P<0.001）和 30-49 岁（OR：1.697；95%CI：1.495-1.926；P<0.001）年龄组的 HIV 相关知识正确比例分别比≥50 岁年龄组高 1.575 倍和 1.697 倍。过去一年中有商业性行为的受试者比例（7.7%-13.3%，<0.001）、此活动期间始终使用避孕套的比例（20.5%-54.0%，<0.001）和最后一次性商业性行为中使用避孕套的比例（48.6%-72.1%，=0.020）呈上升趋势。16-29 岁年龄组过去一年中从事商业性行为的风险是≥50 岁年龄组的 0.768 倍（OR：0.768；95%CI：0.643-0.917；P=0.003）。16-29 岁（OR：2.819；95%CI：2.317-3.431；P<0.001）和 30-49 岁（OR：1.432；95%CI：1.184-1.733；P<0.001）年龄组过去一年中非规律性性行为的风险分别是≥50 岁年龄组的 2.819 倍和 1.432 倍。16-29 岁年龄组过去一年中进行肛交的风险是≥50 岁年龄组的 6.333 倍（OR：6.333；95%CI：1.468-27.327；P<0.013）。过去一年中始终在非规律性性行为中使用避孕套的比例（10.9%-47.3%，<0.001）和非规律性性行为中最后一次使用避孕套的比例（40.8%-71.1%，<0.001）显著增加。16-29 岁（OR：2.606；95%CI：1.847-3.677；P<0.001）和 30-49 岁（OR：1.632；95%CI：1.214-2.195；P=0.001）年龄组过去一年中商业性行为中始终使用避孕套的可能性分别是≥50 岁年龄组的 2.606 倍和 1.632 倍。16-29 岁（OR：1.805；95%CI：1.258-2.589；P=0.001）和 30-49 岁（OR：1.360；95%CI：1.016-1.821；P=0.039）年龄组过去一年中最后一次性商业性行为中使用避孕套的可能性分别是≥50 岁年龄组的 1.805 倍和 1.360 倍。16-29 岁年龄组过去一年中始终在非规律性性行为中使用避孕套的可能性（OR：1.628；95%CI：1.066-2.484；P=0.024）和最后一次性非规律性性行为中使用避孕套的可能性（OR：1.671；95%CI：1.148-2.433；P=0.007）分别是≥50 岁年龄组的 1.628 倍和 1.671 倍。
2010 年至 2018 年期间，重庆 MMWs 中 HIV 呈上升趋势，HCV 呈下降趋势。我们还发现，该人群中商业性行为和高危行为中避孕套使用不足的情况有所增加。中老年人群的总体梅毒流行率高于年轻人群，老年 MMWs 更有可能进行无保护的高危行为。因此，迫切需要针对重庆 MMWs 特别是 50 岁以上人群开展性传播感染预防工作。
